Jennifer
Bremner took up her duties as Director of EHMA (European Health Management
Association) in 2007. Whithin this organization, she is leading EHMAs efforts
to build healthcare management capacity in Europe.

Responsible
for setting strategy, overseeing EHMAs network of over 160 members across Europe, policy work and its operations. Managing a portfolio of 10 EU funded projects
related to research, capacity and network building , translation of evidence
to practice and implementation of best practices in management, governance in
health, policy development, quality improvement, patient safety, eHealth, health
workforce development, cross- border care and mental health.

In the period 2000-2007
she activated as director of some programmes in the field of health management,
coordinated by the Local Government House din Londra, such as: The policy
development for local government association in relation to wide range of
issues including, health, care, prisons, criminal justice, childrens services,
education. Worked with members and represented local government to national
government.

She exercised the function
of Independent Policy Analyst, respectively of Policy Analyst for the trust,
member of Trust Board led policy and health system development for the
organisation and local health system (between 1998-1999).

Since
her onset career (in 1985, as a nurse at a hospital in London), and by this
time, she considered a career locally and nationally, being involved in
activities and functions in the field of health and social assistance, such as:
Health Economist and R&D Manager, Training Coordinator, Planning and
service development Manager etc.

She got Leadership
Skills and Extensive experience in Project Management, Fundraising, Network and
Membership Development, Healthcare Management, Health Policy. Member of the
European Health Policy Forum, Commission Working Group on Active and Healthy
Ageing, Patient Safety and Quality, eHealth, Workforce Taskforce.

Among
the main european projects (financed by European Comission) she participated it
can be include:

Patient Leading and Managing their Healthcare
through EHealth (PALANTE) Operating Grant Financial Year

Feasibility study on the establishment of a
European Sector Council on Employment and skills for Nursing and the Care
Workforce

Reporter: Mrs. Jennifer Bremner, you have a
wide experience in health management and you have been actively involved in the
EHMA activities since 2007. As current director of EHMA which is an
organization that aims to improve health service management in Europe,

- Can you tell us more about the purpose and the
mission of the European Health Management Association?

JENNIFER BREMNER: EHMA is a membership
network set up over 40 years ago, originally to bring together health
management educators across Europe and we still have a vibrant network of
Programme Directors. However it soon became clear that in planning education it
was essential to understand the developing policy framework and the network
expanded to include health policy makers, which led in turn to bringing in
applied health service researchers and of course health services managers.

EHMA is a unique meeting place that brings
together these different sectors, although we input the views of health
managers when asked to, we do not lobby and are not pursuing any particular
political line.

Reporter: As you already
said, EHMA represents also a platform where professionals can meet each other
and where they can share experience and even find solutions for current health
issues. The two networks launched by EHMA (the European Mental Health Systems
Network and the Transitional Countries Network) can be given as example of good
cooperation between groups of health professionals having common goals.

- Please briefly describe some relevant aspects
of this kind of networking.

- What do you consider to be the key elements of
activities carried out in your association?

JB: The other key strength of EHMA is that it
acts as an Agora a meeting place where ideas, the more difficult and complex
the better can be discussed. Through this we hope to build the capacity for
health management in Europe and to also improve the quality of health
management. Ultimately we believe the better the quality of the management the
better the patient care and the outcomes for patients.

As we dont lobby we focus our policy work in
two key areas. The first is bringing the voice of health managers into the
development of European Health Policy. We are privileged to have an invitation
to a number of high-level EU member state working groups. Here we bring the
ideas and challenges facing health managers in Europe into the shaping of EU
policy. We are lucky that a number of our members are able to support us
bringing their specialist expertise right to the heart of EU debates. The
second strand of our policy work is the translation of EU policy to the
national and particularly to the organizational level. We do a regular monthly
EU alert to our members to keep them in touch with the latest developments at
an EU level.

Another key work strand for EHMA is in applied
health service research. Our interest is in how to take ideas and approaches
from one context to another, be that research into practice or moving
approaches from one country to another. We are building a considerable body of
expertise in brokering knowledge, delivering the results of research in
language that policy makers and managers understand and that speaks to the
issues that they are facing.

In such challenging times the added value of
EHMA is even greater, as a meeting place network and expert in ideas into
practice and this is demonstrated by the steady increase in our membership.

Reporter: The concerns of your organization
in improving quality of health management in Europe are visible also through
the results of some of the initiatives started in the previous years, including
ECHO, PALANTE, PROGRESS, PROMeTHEUS which can be considered as successful
research projects.

- Please tell us what were the main results
of these research initiatives and what would be the potential impact on the
health service management improvement (please refer only to one of these
initiatives you considered to be successful).

- What do you consider to be the essential
element in obtaining the desired results?

JB: One of our key areas of research and
interest is in health workforce. We coordinated a three year research project
funded by the European Commission Prometheus on health professional mobility
and have a key role in the new European Joint Action. Both in the Prometheus
study and the RN4CAST study looking at nurse retention, one of the recurring
factors that can either keep or lose staff is the quality of management. The largest
expenditure in our health systems is our staff bill and understanding how to
manage processes effectively, how to support and empower staff to do the best
job they can is a fundamental part of the role of the health manager. We do a
lot of work looking at staff retention, we know from our Prometheus project
that health staff moving to other countries is only part of the problem, often
the larger problem is that number of health staff who leave the health sector
to stay in their country but in other jobs and professions. Understanding the
factors that make staff want to stay and creating health organizations that
people want to work in, will be essential, in times of austerity we need the
commitment of our staff even more. We need to engage staff in working with
managers to create a more efficient system.

Reporter: Your experience in the field of
public health and health management (health policy, health economic, health
management etc) is already exploited at European and international level.
Taking into account the current position and your extensive experience, but
also the consequences of the financial crisis,

- Please summarize the current and possible
problems in the field of public health and health management in Europe. How do you see EHMAs involvement and role in solving these issues?

- In your opinion, what are the best actions to
be taken for health at high standard/quality in Europe?

JB: In many countries health managers have
clinical backgrounds and may have reached a level of seniority before they take
on a management role. No matter whether the manager is a specialized health
manager or a clinician who has moved into that role, providing education and
professional development in the role is as important for managers as well as
clinicians. As more health systems face major changes, some due to the
austerity measures others due to the change in demographics and rising consumer
expectations, good management will be fundamental to achieving successful
change. The challenges that face us are huge and long term. In many crises it
has been possible to manage through by tightening your belt. In this way
survive the lean years until a new period of growth arrives. This crisis is
different both in its depth and its expected duration. Picking up on our theme
of the 2012 conference we held a high level round table on the health crisis
with Professor Richard Saltman at the end of 2012. It was clear from this
discussion that although people recognized the size of the challenge there was
still considerable uncertainty about how to actually address the issues both at
a system and at an organizational level.

More of the same is not a sustainable option for
most European countries. The scale of the challenge requires radical
transformation and radical thinking. It is not clear at this point what future
health systems will look like. We know some of the features they are likely to
include; such as more self managed care, new health professionals specializing
in multi morbidity and a significantly reduced role of the hospital.

However all of these bring major challenges for
both patients, their families and for health professionals. They also assume a
formal or informal social infrastructure that will support people in homes that
are appropriate for care. In EHMA we believe that the future of our European
health systems depends on how we learn from each others successes and
failures.

A lot of attention is being given to delivering
efficiency savings, providing more of the right care and no longer providing care
that has little or no therapeutic value. Estimates of the savings that this
might realize range from 10 to 40% of total health care budgets. Certainly
efficiency savings are essential, however alone they are unlikely to release
sufficient resources to maintain our current models of care. It is important
that efficiency savings are used to develop and implement profound system
change. These are challenging times where the vision of the future is not
clear.

Reporter: One of the most important event in 2012
was represented by the EHMAs Annual Conference Who pays, who provides,
hosted by the University of Bern.

- What do you propose by organizing events like
this annual conference? and

- What are other events do you consider that can
offer benefits to all members of the association you coordinate it?

JB: As an association, we aim to use our events
and our alliances to explore these challenges. Our two flagship events, the
Annual Conference an interactive event that brings together Research, policy,
education and management at the end of June. The second is our annual
Winterschool, this is a smaller event aimed at senior leaders that is designed
to allow in-depth exploration of ideas and challenges. This is a very sought
after event as it one of only a handful of opportunities for senior European
leaders to meet and share.

We also have a number of networks such as the
programme directors network for people leading health management programmes,
but others looking at workforce issues, mental health and challenges facing new
member states and neighborhood countries. Our networks, bring together
professionals sharing common goals from different countries. There is real
strength in exploring problems across national contexts with people who dont
share the same assumptions about what is possible. Often this can lead to
problems being redefined, for example if people from five different countries
with five very different systems are all trying to solve the same problem it is
unlikely to be caused by the countries policy context but to be a more
fundamental system issue.